MEDICARE: PSOK PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336L0003X	Long Term Care Pharmacy
3	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	15242286-05	OTHER	OK	ST TAX PERMIT
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	3730480	OTHER		NCPDP
4	64512	OTHER	OK	OBN
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871053538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSOK PHARMACY INC

Provider Business Mailing Address
First Line	:	1035 36TH AVE NW
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73072-4185
Country	:	US
Telephone Number	:	405-364-5222
Fax Number	:	405-364-7076

Provider Business Practice Location Address
First Line	:	900 N PORTER AVE STE 101
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73071-6426
Country	:	US
Telephone Number	:	405-364-5222
Fax Number	:	405-364-7076

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. WILLIAM E OSBORN
Credential	:
Telephone Number	:	918-542-4444

Provider Enumeration Date	:	03/20/2019
Last Update Date	:	03/10/2026

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Directions to “PSOK PHARMACY INC ” Practice Location

Language	Start Address	Practice Location

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